CPO volunteer application

Volunteer Application:
Name

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail
How did you hear about us?*
Are you looking to volunteer one time, or ongoing?*

One timeOngoingNot sure
If one time, please list the date:

MonthDayYear
Date
If ongoing, please list a date range (i.e. 5/15/20-12/10/20):
Do you need a specific number of hours, if so please enter below.

Emergency Contact Information:*

	Full Name	Contact Number	Relationship
1
2

Please list any limitations or requirements you may have so that we may accommodate you (i.e. allergies, medical conditions, physical limitations, etc.)*
Availability: morning

MondayTuesdayWednesdayThursdayFriday
Availability: afternoon

MondayTuesdayWednesdayThursdayFriday
Availability: evening

MondayTuesdayWednesdayThursdayFriday
What area are you interested in volunteering? (You may select more than one)

Affordable Housing and Homeless Prevention/O'Reilly Center for HopeCommunity and Neighborhood DevelopmentPrevention and Youth SupportEarly Childhood and Family Development
What specific skills and/or talents can you share with us? This will help us match volunteer opportunities to skills and interests (choose all that apply).*

Marketing/promotionLeadershipPublic SpeakingResearchFacilitation/trainingFundraisingDirect ServiceOther, please specify below.
Other
Have you completed a background check (within the last 12 months) prior to submitting this application?*

YesNoI've got a current background check on file with another organization/business/school that I can share.
Would like to receive regular updates about CPO via our newsletter?*

YesNo
I grant CPO permission to use any photographs/video taken of me while I'm volunteering at CPO, in conjunction with the publicity of their programs/organization.*

YesNoI don't know
By signing below, you are finalizing your volunteer application, releasing CPO from all liability including injury or damages sustained by any volunteer while participating in any CPO supported/sponsored event or activity, and acknowledging that you understand that all contact with the media whether print, television, radio, online or other shall be handled by CPO staff only. You agree that unless you are asked by CPO to be part of a story or feature, you are not permitted to talk, with or contact the media as a representative of CPO. You understand that failure to comply with this policy may result in dismissal as a CPO volunteer. Please sign and submit.*

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Volunteer Application: